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HE PROPHYLACTIC VALUE OF 
INSTRUCTION OF CHILDREN 
IN THE ELEMENTS OF 
PHYSIOLOGY OF SEX 

BY 

CHARLES A. PFENDER/M. D. 

WASHINGTON, D. C. 






THE PEOPHYLACTIC VALUE OP INSTRUC- 
TION OF CHILDREN IN THE ELEMENTS 
OF PHYSIOLOGY OF SEX.* 

BY 

CHARLES A. PFENDER, M. D., 

WASHINGTON, D. C. 

The true object of the normal sexual function is 
the reproduction of the species. In animal life sexual 
selection insures a survival of the fittest, as these will 
leave most progeny. In man actual conditions prove 
the reverse to be true, hence we are forced to conclude 
that the unfit should not be allowed to breed children. 

The power for the prevention of the procreation of 
children by criminals, mental degenerates, syph- 
ilitics, and the like, is, unfortunately, greatly 
restricted. It is true that certain States have 
recently enacted laws for the prevention of procrea- 
tion by confirmed criminals, idiots, imbeciles, and 
rapists confined in state institutions, and the rigid en- 
forcement of -these laws would no doubt prove most 
beneficent, but, as a matter of fact, the work would 
extend to comparatively few physical and mental de- 
generates. 

The physical perfection of mankind rests in the sex- 
ual domain of those now living. If we would beget 
physically and mentally healthy offspring, the ma- 
ternal and paternal ancestors must necessarily be en- 
dowed with these characteristics. Under existing con- 
ditions we can at least hope for a reduction in the 
procreation of the degenerate types. 

The cause of the degeneration of mankind lies large- 
ly in sexual irregularity. Sexual impurity is the 
natural outgrowth of the non-enlightenment of the 
past and present generations during childhood in the 



*Presented to the Section on State Medicine and Public 
Hygiene, State Medical Association of Texas, Amarillo. 
May 9, 1911. 



physiology of sex. How few are present today who 
can testify that they received the proper instruction 
during early youth in matters pertaining to sex, and 
were thus safe-guarded from the pitfalls bordering 
the pathway of the sexually ignorant youth ! A little 
personal introspection would reveal many who would 
gladly have profited by these teachings. 

It is my belief that the instruction of the coming 
generations in sexual matters during childhood will 
prove the only effective means of even partially cop- 
ing with the question of the prevention of the breeding 
of further physical and mental degenerates. The 
time has come when we can no longer afford to take 
a negative stand on. this issue. We must acknowl- 
edge, willingly or reluctantly, as the case may be, that 
the greatest problems of the day are the child prob- 
lems. The past has had entirely too much advocation 
of woman's rights and far too little thought for the 
child. Sanitarians, social hygienists, pedagogues and 
leaders among the medical profession have of late, 
however, manifested an intense interest in the better- 
ment of existing conditions of society, and the general 
practitioner, and the family physician in particular, 
need to be fully aroused to their duty of directing and 
supervising the methods of prevention suggested for 
their relief. As yet the number of reformers is very 
small, for they comprise the proverbial "drop in the 
bucket" among the vast mass of humanity still una- 
ware of such movement, and whose co-operation is 
necessary if these efforts are to be crowned with 
success. 

In the general consideration of the child it is of 
vital importance to remain cognizant of the fact that 
its development is to a great extent determined by 
prenatal and postnatal environments. It is not yet 
definitely known to what extent environmental condi- 
tions during the period of gestation affect the fetus, 
but there remains no doubt in the minds of careful 
observers that the physical condition of the expectant 



mother is an important factor in shaping the future 
development of the child. 

Society assumes the burden of amelioration or re- 
moval of extraneous conditions or environments that 
menace the future of the child through the imperfect 
function of Mothers' Relief Societies and similar or- 
ganizations. This phase of the work should receive 
much more wide-spread attention, as it is at present 
limited to large cities where the need is greatest, 
as they contain over 40 per cent of our entire popula- 
tion. The smaller towns, suburban and rural commu- 
nities, do not share in the results of organized meas- 
ures for relief and it may fall to the State to install 
practical supervision. 

Every medical man should be primarily an author- 
ity on health as well as disease. The medical pro- 
fession, and the family physician in particular, should 
seek to insure the best possible physical condition of 
the hopeful mother ; he should strive to prevent ab- 
normal developments, or to ameliorate them should 
they exist. It is his duty to impress upon the minds 
of his patients the advisability of engaging medical 
attendance early in the period of gestation. Once 
engaged, his duty should not rest solely in the service 
rendered during delivery of the child and during the 
puerperium, but he should be obliged to enact care- 
ful supervision throughout the entire period of gesta- 
tion, thereby insuring proper nutrition of the mother 
and hence, necessarily, of the fetus, thus preventing 
defects in the offspring. Indigent cases should be 
provided with proper care and supervision by the 
State. 

As already stated, we have no means of preventing 
the procreation of undesirable offspring. Surely no 
one could reasonably contend that it should not be 
interfered with, yet, so long as society permits the pro- 
creation of this type so long will it be obligated to 
provide for its sustenance. Society has no right to 
deny existence to a child once it is born. No matter 
how low and undesirable the type may be, the child 



has a God-given right to look to society for the preser- 
vation of its life and health. It is entitled to a full, 
normal period of childhood, and it has a right to edu- 
cation. In the proper education of the child we have 
the key to mental, moral and physical development of 
the highest degree. If the parents cannot or do not 
provide for these children then the Stite should ex- 
ercise this right. 

I want to emphasize here certain phases of the edu- 
cational obligations of society. Neither time nor space 
permit extensive detail' and a mere outline of the most 
important facts must necessarily suffice. 

Child education should begin in the home. It is 
only through the intelligent education of the present 
generation that the future fathers and mothers will 
obtain the training that will enable them to correctly 
transmit needed knowledge to their children. Moral 
education, of course, should and does largely precede 
all other forms of instruction. The earliest impres- 
sions .of childhood are shaped by environment, either 
good or evil, and it requires no super-intelligent mind 
to grasp the importance of insuring the proper di- 
rection of such impressions during the formative 
stage of mental development. Unfortunately this 
phase of home moral training in earliest life is still 
woefully deficient and demands much further thought 
and study. 

The literary training of the child has been well pro- 
vided for by society, both in the home and in the 
public schools. The idea that at least a moderate 
amount of literary instruction is essential if the child 
is to reap the full benefit of industrial education, 
is recognized more fully now than ever before. 
Literary and moral education in the schools have long 
been provided for and recently industrial training 
has found a permanent foot-hold in the curriculum of 
child education. Instruction in matters of equal if 
not greater importance, matters dominating the prin- 
ciple of life itself, on the other hand, lias been en- 
tirely ignored until recently. The crying need of 



instruction during childhood in the elements of physi- 
ology of sex has aroused the thinking population of 
the entire world to a higher degree than ever before 
and the logical result is an insistent demand for such 
instruction along scientific lines. 

Ivan Bloch succinctly states that "Correct sexual 
education forms the foundation for the ennoblement 
and resanation of our entire sexual life," and there 
are very few intelligent persons who are ready to de- 
clare that under the present social conditions boys 
and girls do not need instruction in the fundamental 
facts of sex. The strongest argument that has been 
brought forward by the opposition to this movement 
seems to be the "shattering of the illusions" fostered 
by children. If we would recall that these illusions 
are intrinsically erroneous and harmful, that they do 
not fit into the real plan of our existence, that they 
are not safe-guards but veritable decoys of mischief 
and even vice, we cannot fail to note that the pre- 
vention of such illusions by proper instruction would 
spare youth much future disappointment and sorrow 
when brought into direct contact with the true state of 
affairs unprepared to meet the problems of life in- 
telligently. 

It is difficult for any one familiar with actual con- 
ditions, to escape the conclusion that instruction of 
children in the fundamental principles of sex physi- 
ology, partly in the home and partly in public schools, 
will be the direct means of preventing by far 
the greater portion of suffering and vice which 
abounds and whose origin has been conclusively 
traced to an unenlightenment of children, and youths 
in particular, in matters pertaining to sex. 

Do you know that of the 14,000,000 male adults 
under the age of 30 in the United States, 8,000,000, 
according to the calculation of most careful observers, 
have gonorrhoea? Do you know that Germany alone 
has 30,000 cases of blindness due to sexual disease, and 
that in our country nearly 40 per cent of all cases 
of blindness — and we have 110,000 blind people 



among us — are the result of transmission through 
sexual disorders? Do you know that Price found 
among 1,000 abdominal operations performed on 
women, 950 were the result of conditions due to 
one form of sexual disease alone? Do you know 
that in France nearly 25,000 children die annually of 
hereditary syphilis ? Do you know that 25 per cent 
of all the blindness in the world is being caused by 
gonorrhoea alone, and many more cases by other forms 
of sexual disease? Add to these numbers the large 
host of men and women afflicted with various nervous 
and mental diseases, whose origin is based on sexual 
irregularity, and the result will astound even the most 
credulous. 

These facts confront us today and we must prepare 
to meet them now. 

If the farmer, for instance, mav profit by instruc- 
tion which transforms him into a scientific agricul- 
turist, does it not seem reasonable to conclude that the 
application of a method of instruction in sexual edu- 
cation for non-enlightened youth would prove equally 
as beneficent to humanity, if not more so, under pres- 
ent conditions? And, in so much as the result of 
proper instruction in sexual physiology promises, to 
say the least, a mentally and physically more healthy 
race of boys and girls and consequently sound hus- 
bands and wives well equipped for the propagation 
of healthy specimens of the genus homo, we are ob- 
liged to give this phase of education most careful con- 
sideration. The leaders of society engaged in the 
glorious work of uplift of humanity, are at least 
agreed that no other avenue" of hope exists this side 
of the millenium, and it is the duty of the medical 
profession to conform to the times and to promote 
such measures as make for healthfulness, and pros- 
perity and happiness will be a logical sequence. 

The inauguration of courses in sex physiology in 
public schools will not prove so difficult as some may 
apprehend. It will no doubt be necessary to install 
graded classes in this branch of study, arranged ac- 



cording to the age and mental development of the 
child. When instruction should begin is perhaps 
best answered by Oker Blom, "Better a year too early 
than an hour too late." It will depend to some ex- 
tent on environments. The child residing in a small 
town or rural district will require instruction less 
early than the city bred child, reared in an atmos- 
phere where exposure is imminent at any time. 
. I incline to the belief that the selection of a defi- 
nite period of time, preferably during the spring of 
the year, for the study of sex physiology, along the 
lines of the proposed "Health Week" would prove 
successful. The instructors should be carefully 
chosen, and, if possible, one or more speakers of recog- 
nized ability in this line of educational work should 
be invited to lecture to the different classes. 

There are always some who will object to any pro'- 
gressive movement for financial reasons, but the broad 
humanitarian ideals of today are non-mercenary and 
the possible help to mankind of this particular move- 
ment attains such magnitude that when it is once fully 
demonstrated there will be no lack of support. The 
greatest sanitary campaign the world has ever wit- 
nessed — the eradication of hookworm disease — is even 
now being carried on gratuitously. Personal contact 
with the men engaged in this grand work will convince 
you that they are actuated and vivified solely by the 
all powerful spirit of humanity. The efforts of this 
highly organized band of co-workers are proving even 
more successful than was at first anticipated. The 
opposition that was encountered in the beginning has 
been won over by the loyalty of spirit displayed by 
the corps and is. now most assiduous in rendering sup- 
port. It is a similar spirit that endows the movement 
of education of children in sexual matters. The entire 
world is its field of operation, its opportunities know 
no boundaries and. the pioneers will be called blessed 
by their descendants. 



FEB 23 1912 



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